Treatment approaches for congenital pseudarthrosis of tibia: Results of the EPOS Multicenter Study

This study was designed to analyze the different therapeutic methods used b y European Paediatric Orthopaedic Society members from 13 countries for con genital pseudarthrosis of tibia. The treatment data of 340 patients who und erwent 1287 procedures for this condition were analyzed. The essential find ings were that the method of choice needed to approach the biological probl em with the aims of: (1) resecting the pseudarthrosis to provide stability, the basic requirement for bony consolidation; (2) correcting length discre pancy and axial deformity; (3) achieving fusion; and (4) solving the additi onal problems around the main deformity such as alignment, leg length discr epancy and ankle valgus. The Ilizarov technique emerged as being the optima l method, having the highest rate of fusion (75.5%) of pseudarthrosis and r ate of success in correction of the additional deformities. There was also consensus that surgery should be avoided before the third year of life.